Retrospective study of the incidence of portal vein thrombosis after splenectomy in hematological disorders: Risk factors and clinical presentation

Objective: Portal vein thrombosis (PVT) has been described as a rare complication after splenectomy. PVT associated risk factors after splenectomy in hematological disorders are poorly recognized. The aim of this study was to assess the prevalence and risk factors of PVT incidence in splenectomized patients.

Methods: One hundred twelve splenectomized patients with various hematologic diseases between 2008 and 2018 were enrolled in this study. Diagnosis was confirmed by Doppler ultrasonography (DUSG) and risk factors for PVT were sought based on the comparison of clinical and laboratory features between patients without and with PVT.

Result: PVT was diagnosed in 4 (3.57%) patients in spite of receiving antiplatelet therapy. Patients with PVT were β-thalassemia major (n = 2) and β-thalassemia intermedia (n = 2). β-thalassemia patients had a 3.5 times higher odds for PVT (95% CI: 2.41-5.33). No significant differences between patients with and without PVT in terms of age, gender and laboratory features were found.

Conclusion: According to our data, β-thalassemia, especially intermediate form, may be a risk factor for PVT and it can occur in spite of receiving antiplatelet therapy. Given that β-thalassemia patients are at risk, early PVT detection may be useful for reduction of fatal PVT complication in splenectomized patients.